IBPO Police

• Agreement Between the Town of Madison and The International Brotherhood of Police Officers, Local 456
• Police Pension

Life Insurance

• Life Insurance Enrollment and Change Form
• Family Medical Leave Act (FMLA)
• FMLA BrochurePDF Overview of FMLA
• Notice of Obligations PDF Outline of the Obligations of Employees Who Take FMLA
• Employee Request for FMLA Form  PDF

Medical and Health Care Forms

For information regarding your Anthem Blue Cross Blue Shield coverage, you can request information on your summary plan document by calling 800-233-4947 which is the customer service number on your insurance card. You'll be asked to provide your Subscriber number (which is on the front of the card) and they will send the document to your home.

• Open Enrollment for Health Coverage
• Salary Reduction Agreement
  Selection of Benefits
• Payment in Lieu of Benefits Form
• Anthem Rx Direct Order Form
• Anthem Claim Form
• Enrollment and Membership Change Form
• COBRA Notification Letter
• Bluecare Option 1 - Description of Benefits
• Bluecare 3-Tier Prescription Plan
• Bluecare Vision
• Century Preferred - Cost Share
• Century Preferred 2-Tier Prescription Plan
• Century Preferred - Vision Care Plan
• Dental Plan Summary Description
• Generic Select Program